Productive Member
Just had my first taste of Tren cough! Wow! I must have nicked a vein because I aspirated well. But, I had just finished my injection and I got this funny feeling in my throat and here came the cough! Only lasted about 5 minutes though. I'm headed to workout, will it be a problem at the gym?
Associate Member
Should not be a problem at all. I go full tren cough every time I shoot the stuff. I guess i'm really sensitive? But yeah, i've never had trouble past 5-10 minutes post injection. I don't see why it would stop you from hitting the gym
Member
I hope for the cough!
Productive Member
[QUOTE="212OlympiaBound"]Should not be a problem at all. I go full tren cough every time I shoot the stuff. I guess i'm really sensitive?
Man I appreciate the response. I've used Tren for the past two cycles and I can't ever remember it doing me like that. Same gear too. It freaked me out a little, but only lasted about 10 minutes. And, I didn't have any problems in the gym. Thanks again for your knowledge! I'm still fairly new at this.
Productive Member
Forgive me for posting inside your response and cutting off half of it! I haven't read how to respond properly.Originally Posted by Strongblood
Productive Member
Really? Is a better dose when that happens?
Anabolic Member
Try injecting it very slowly next time. For me,,it helps me avoid the cough.
Member
Now I think it's just psychosomatic! Makes me think it's just climbing up on me.
Productive Member
Lol! Yea I know what you mean! You definitely know it's there when that happens!
Productive Member
Ok. You know now that I think about that, I did rush the last half of my dose a bit! And I got blood after I withdrew the needle. But that's happened before.
Productive Member
Put ur head into a pillow and cough away lol..
Associate Member
I've never tried tren, but i have a cycle planned for it. So is it 100% possible to cough after tren injection? Or all of the guys here are sensitive? If i don't cough , does it mean the tren is not tren??
Member
If your tren is good you will get the cough before you get thru the first bottle! Haha! You don't even have to nick a vein! I don't aspirate so I've actually had one when I pulled the needle out shot blood about 2 feet across the bathroom 2 seconds later boom lungs full big ass cough to my knees! Man I love that shit!
Knowledgeable Member
Aspirating is great to make sure you are not "currently" in a vein.
However aspirating (usually) will do nothing to tell you if you have gone through a vein on the way in, or if you will nick one on the way out.
OK Here is my two cents on what actually happens in most cases of non productive cough after intramuscular injection of oil based steroids. I have no medical citations to back this theory but believe me when I say I am pretty damn sure this will be discovered to be the case one day and you can say you read it here first (ego check) LOL
This is why it is so important to inject SLOWLY as well as rotating sites regularly.
If you don't rotate sites regularly your injection sites will become damaged and less willing to allow AAS to spread through the adjacent muscle tissue, this will cause the oil to (briefly) be stored under pressure in a pocket where you injected instead of dispersing through the adjacent tissue. Then if you have nicked a vein on the way in or out the AAS within the depot may be at a greater pressure than the blood within the vein causing some of it to migrate into the vein (I use the term vein loosely as it seems to be the accepted term, more likely capillary would be more accurate) Same thing is true of injecting quickly, you will cause a high pressure deposit of AAS at the injection site making migration of AAS into any damage in the vascular system more likely.
Last edited by Far from massive; 09-17-2015 at 03:39 PM.
Knowledgeable Member
No it does not, back when I first started using AAS I never had Tren cough once. At that time I was using Tren made from pellets so for sure it was real LOL. Not only that my dumb ass was doing Tren only cycles and injecting Tren by itself as opposed to Tren cut with test (This, mixing Test and Tren 50/50 in the same syringe makes it a lot less violent) However at the time I was only doing gluteal shots and of course had virgin flesh so rapid absorption was a given.
However these days after years of pinning tons of gear I will get some form of Tren cough about every 8th shot in the quads and every 25th or so in glutes and delts. I attribute this to damage to the sites over time but this is only an assumption.
Member
^^^^^ you may very well be correct! I don't inject quickly and have never had the cough with just tes and we are talking 6 yrs twice a wk at least so that's a bunch of chances for it to happen. With tren it always is going to happen about 40 percent of the time. I believe tren migrates thru the muscle fibers quicker and is absorbed more prolifically. So I believe if you inject too fast it most definitely could contribute to a quicker absorption factor.
Anabolic Member
Some.are more sensitive than other...
And tren cough isnt supose to hit every shot if so you are doing something wrong.
But eventually youll end up living it.
Maybe not your first vial but eventually is sure. My first was at my.fourth vial.
Now I got one every few shots...
Tren is tren you must deal with the cough...
Member
Far from massive Ha you were typing at the same time but you say 25% when in glutes and glutes are all I hit and its 40% so pretty close. Info like this is the only way we can even try to figure tren out due to its intended purpose. Truthful info from real experiences is the only way we can compile any kind of data on this wonderful compound.
Associate Member
I think it is highly person-dependent.
Me and my good friend use the same tren (order at the same time). we've both been using this stuff for a long time and have very similar injection technique. I cough every time, and he has never coughed
Productive Member
Lol like I said before u will feel it come on and once u do just push ur head into the pillow and let it out. BTW u will feel like ur going to die from coughing so much but it will be gone in a couple minutes. I normally get the cough from flute injections not quad injections.
Knowledgeable Member
I've done several Tren cycles and never had the cough once.
Neurologically Intact
Shit - Last night the wife had of gone straight into a vein on the way out.
I locked up - I thought I was gonna puke for a while. Had to get my inhaler to pull through.
Yet, I still never found an exact answer on why we get the cough. First I thought it was the alcohol content. But, now I am kinda thinking it's caused by the actual dissolved hormone which oxidized in the liquid. < I'm thinking this now, since no other compound gives me a cough - yet, has the same solvent content.
Associate Member
It is definitely specific to tren. Although, with other hormones, if you shoot directly into a vein, you can get similar symptoms such as a small tightening of the chest
Senior Member
I nick a vein with test and get the cough. It is an automatic response mechanism. I get it more often with my test shot than my tren shots.
Anabolic Member
You know how sometimes when you are done injecting and when you pull out the syringe, a little oil or blood can leak out of the injection site? Even if you aspirate, this only means you are not in a vein at that moment, but you may have nicked one going in. When you pull out the syringe, the oil that is coming out the hole can enter the blood stream this way and cause you to cough. It is not specific to strong or weak tren in my opinion. It simply means a little tren got into your blood stream. I had it so bad a few weeks ago that my teeth actually hurt before I started coughing. Ha ha. It is just part of the game and luckily goes away fairly quickly. But, it certainly is scary the first time it happens.
Banned
Def something i had to deal with but it was reassuring that to me that it was potent...Or at least my lungs thought so....Had a huge scratching pain in my lungs the day after one specific time and i was doing 50mg ed so i was nervous/pissed going into that next day that i was gonna get it again...Luckily didn't...Already stopped that cycle but not due to tren cough
VET
I just had my first tren cough(not even 1/2way thru my first vial) -- must have nicked a blood vessel/capillary as I wasn't even half way through my shot and it started climbing up on me lol.... I will also say I've gotten it on test as well.... I aspirate - and it always goes in so smoothly yet I'll pull the syringe out slowly and bam! Few and far between although I'm thinkin w/this tren it may be different(+ I used 2.5-3min for2.5cc)
Last edited by NACH3; 09-19-2015 at 07:25 AM.
Productive Member
Yes it is scary the first time. This was my 3rd cycle of Tren and never experienced it. Tren cough is a side effect that should get more attention with Tren use. Some poor bastard could check out thinking he was having a dam heart attack with it! Lol! I know I would have been a sight! Naked laying in the floor with a syringe stuck in my ass, mouth wide open, tongue hanging out, with a f**k me look on my face!
Knowledgeable Member
Any oil based steroid can cause a non productive cough after absorption into the circulatory system. This is because oil will cause microembolism's at the capillaries in the lung. When Tren will cause a much more violent reaction is open to speculation but one thing for sure it does LOL.
PS I found a medical article a few years ago that cited a 1.5% rate of cough when injecting IM test for TRT usage.
Knowledgeable Member
Hey found the original article as well as a second article citing a pretty scary case of a guy who had a severe reaction after self injection.
Hum Reprod. 1995 Apr;10(4):862-5.
Tolerability of intramuscular injections of testosterone ester in oil vehicle.
Mackey MA1, Conway AJ, Handelsman DJ.
Author information
• 1Andrology Unit, Royal Prince Alfred Hospital, Sydney NSW, Australia.
Abstract
We undertook a prospective survey of the tolerability of deep i.m. injections of testosterone enanthate in a castor oil vehicle, the most widely used form of androgen replacement therapy. Over a period of 8 months, 26 men received 551 weekly injections into the gluteal, deltoid or thigh muscle and side-effects were recorded immediately and 1 week after each injection by the same nurse using a standardized questionnaire. Most injections caused no complaints [389/551, 70.6% (95% confidence interval 66.6-74.4%)] but minor local side-effects, mostly pain and bleeding, were common [162/551, 29.4% (25.6-33.4%)]; no serious side-effects were observed. Considering all side-effects, the gluteal site had fewer complaints and was less prone to bleeding but was painful more often than deltoid or thigh injection sites. The laterality of injection at any site had no significant effect on side-effects. The only systemic side-effect was episodes of sudden-onset, non-productive cough associated with faintness following eight injections [1.5% (0.6-2.9%)] which we speculate may have been due to pulmonary oil microembolism. We conclude that, when administered by an experienced nurse, deep i.m. injection of testosterone enanthate in a castor oil vehicle is generally safe and well tolerated but causes relatively frequent minor side-effects, including pain and bleeding. An improved depot form of testosterone would be highly desirable for androgen replacement therapy and hormonal male contraception.
Here is a really scary case,
Can Respir J. 2011 Jul-Aug; 18(4): e59–e61.
PMCID: PMC3205107
Language: English | French
Acute respiratory distress following intravenous injection of an oil-steroid solution
Michael Russell, MD PhD,1 Aric Storck, MD,2 and Martha Ainslie, MD3
Author information ► Copyright and License information ►
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Abstract
A case of acute respiratory distress and hypoxemia following accidental intravenous injection of an oil-steroid solution in a body builder is presented. Chest roentography at the time of presentation showed diffuse bilateral opacities, and computed tomography revealed predominantly peripheral ground-glass opacifications. The patient’s symptoms gradually improved over 48 h and imaging of the chest was unremarkable one week later. The pathophysiology, diagnosis and treatment of this rare but potentially life-threatening complication of intravenous oil injection are discussed.
Keywords: Pulmonary oil embolism, Steroid-oil injection
Résumé
Est exposé le cas d’un culturiste qui a souffert d’une détresse respiratoire aiguë et d’une hypoxémie après l’injection intraveineuse accidentelle d’une solution d’huile de stéroïdes. La radiographie pulmonaire à la présentation a révélé des opacités bilatérales diffuses, et la tomodensitométrie, des opacifications périphériques en verre dépoli. En 48 heures, les symptômes du patient se sont graduellement résorbés, et l’imagerie des poumons ne révélait plus rien d’exceptionnel une semaine plus tard. Les auteurs présentent la physiopathologie, le diagnostic et le traitement de cette complication rare causée par l’injection d’huile par voie intraveineuse et qui peut mettre en jeu le pronostic vital.
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CASE PRESENTATION
A previously healthy 21-year-old man presented to the emergency department with acute onset dyspnea approximately 24 h following self-administered injection of an oil-steroid solution into his right buttock. The patient admitted to a single injection of a mixture of anabolic steroids suspended in oil, including commercially available preparations of testosterone enanthate and boldenone undecylenate. At the time of injection, he aspirated blood before administering the anabolic steroid, then repositioned but did not withdraw the needle. Within 1 min of injection, he developed transient shortness of breath that resolved initially but subsequently recurred and progressed to the point he presented to the emergency department 24 h later.
Medical history was significant for a previous emergency room assessment for acute respiratory distress, at which time pulmonary embolus was ruled out with a computed tomography (CT)-pulmonary embolism protocol. The patient was a nonsmoker, and denied recreational or intravenous drug use, significant alcohol use or any recent unusual inhalation exposures. He was self-employed as a tattoo and graphic design artist. The patient indicated that he had been sexually active with multiple partners over the previous year and had tested negative for both HIV and hepatitis C virus within the year before presentation.
The patient was hypoxic at rest, with oxygen saturations of 88% to 92% on peripheral pulse oximetry, and experienced significant desaturation to 82% to 85% with minimal activity. Heart rate, blood pressure and temperature were within normal limits. A physical examination revealed a fit man of average height and weight with a muscular build. The patient’s work of breathing was normal when stationary, but he rapidly became tachypneic on exertion. Lung auscultation revealed decreased breath sounds in the lower lung fields, with coarse crepitations and faint expiratory wheezing bilaterally, as well as a mildly prolonged expiratory phase. The remainder of the physical examination was unremarkable, notably including an absence of petechial rash and a grossly normal neurological examination.
Complete blood count plus differential, serum electrolytes and coagulation studies were within normal limits. D-dimer was elevated at 1.43 mg/L (upper limit of normal for reference range 0.51 mg/L). An electrocardiogram and urinalysis were unremarkable. Arterial blood drawn in the emergency department for gas analysis on room air demonstrated mild alkalosis (pH 7.45, calculated HCO3 25 mmol/L) and significant hypoxemia (arterial PO2 54 mmHg) with no evidence of hypercapnia (arterial PCO2 36 mmHg).
A chest x-ray taken at the time of initial assessment showed diffuse bilateral opacities (Figure 1A) and CT-pulmonary embolism of the thorax revealed multifocal regions of ground-glass opacification in a predominantly peripheral distribution throughout the lungs, but no evidence of pulmonary embolus (Figure 1B). The patient was admitted with a working diagnosis of pulmonary oil embolism and started on supplemental oxygen therapy at 2 L/min via nasal cannula.
Figure 1)
A Chest radiograph showing diffuse opacification and increased vascular markings bilaterally. B Axial slice from computed tomography scan of the thorax demonstrating discrete ground-glass opacities bilaterally in a peripheral predominant distribution. ...
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DISCUSSION
The present report is the first to describe a case of pulmonary oil embolism following accidental intravascular injection of an oil-steroid solution. Acute lung injury and respiratory distress following intravascular introduction of oil is uncommon and has only been described in a small number of case reports (1–6). The pathophysiology underlying this phenomenon is postulated to be similar to that observed with the more extensively studied fat embolism syndrome (FES). Although the precise mechanism by which intravascularization of lipid emboli leads to the clinical features of FES has yet to be completely described, two theories have been proposed to explain the pulmonary dysfunction that occurs.
The mechanical theory postulates that fat emboli become physiologically lodged in the pulmonary capillaries, resulting in a ventilation-perfusion mismatch. Alternatively, the biochemical theory suggests that hormonal changes induce the systemic release of free fatty acids that are toxic to pneumocytes and the capillary endothelium of the lung, causing interstitial hemorrhage, edema and chemical pneumonitis (7). A symptom-free period precedes the development of clinical features, suggesting that the formation of toxic biochemicals is necessary for the clinical syndrome to develop. The mechanical and biochemical theories are not mutually exclusive and the clinical picture associated with pulmonary oil embolism likely results from several physiological processes.
FES is characterized by an initial asymptomatic latent period following introduction of lipid emboli into the systemic circulation, with subsequent development of ventilation-perfusion mismatch and toxic insult to pneumocytes and capillary endothelial cells resulting in dyspnea, tachypnea and hypoxia within 12 h to 72h after lipid embolization (7). The clinical presentation of FES is highly variable, ranging from asymptomatic to mild respiratory distress, hypoxia and non-productive cough, to the life-threatening triad of FES consisting of respiratory difficulty, petechial hemorrhages and neurological changes. The classic triad of FES is relatively uncommon, occurring in only 3% to 4% of cases despite the relatively high incidence of fat emboli following long bone fractures (greater than 90%) (8–10). The relatively low incidence of symptomatic events following intravascular introduction of lipid emboli suggests that the majority of cases of lipid embolization are not clinically relevant and go undetected.
Diagnosis of respiratory distress due to intravascular oil embolization can be challenging given the nonspecific nature of the symptoms and the latent period that often precedes symptom onset. Bronchoalveolar lavage to detect fat droplets in alveolar macrophages has been examined as a means to diagnose pulmonary fat emboli (11); however, the invasive nature of this procedure limits its utility as a diagnostic tool. Furthermore, no uniformly specific diagnostic imaging findings have been described to date. However, several case reports have identified patterns that may be suggestive of pulmonary lipid embolism in the appropriate clinical setting.
Kiyokawa et al (3) reported finding a combination of interstitial and alveolar patterns in a peripheral-predominant distribution on chest roentography in a case of acute lung injury following intentional injection of vegetable oil. The authors noted, however, that in most cases, chest x-ray findings are normal. Arakawa et al (12) reviewed chest roentograms and CT scans of six patients with pulmonary FES, and found focal areas of consolidation and/or ground-glass opacities with a predominantly upper lobe distribution as well as diffuse ground-glass opacification in the majority of cases. Moreover, Malagari et al (8) described bilateral ground-glass opacities with a predominantly peripheral distribution on high-resolution CT imaging of the thorax in mild pulmonary FES. Although not diagnostic of fat embolism, these imaging patterns – similar to those observed in the present case – may be suggestive in the setting of a compatible history and physical findings. Although specific features on high-resolution CT imaging of the chest were reported in this case series, the diagnostic value of this imaging pattern in the setting of a highly variable clinical picture remains to be determined.
Treatment options in cases of suspected or confirmed pulmonary oil embolism have been largely limited to supportive care in previous reports of intravenous lipid injection (1–6). Chin et al (13) reported the successful treatment and subsequent resolution of one case of idiopathic lipoid pneumonia with oral prednisolone. However, we were unable to locate any other reports or controlled studies to validate the use of steroids as a therapeutic option in the treatment of pulmonary lipid emboli. Therefore, the best treatment at this time remains early diagnosis and introduction of supportive care measures.
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CONCLUSION
In contrast to classic cases of FES, which are typically preceded by a symptom-free latent period, the patient described in the present report experienced an acute dyspneic reaction following introduction of oil into the blood stream. Similar reactions preceding the development of overt pulmonary lipiodol embolism have been described within 1 h of transcatheter arterial chemoembolization for hepatocellular carcinoma (14), suggesting that introduction of lipid droplets into the circulation can lead to rapid onset of respiratory distress. The injection of oil-steroid solution was unwitnessed in the present case and it was, therefore, difficult to discern whether the initial shortness of breath was truly respiratory difficulty due to arterial injection of oil or more a subjective experience related to the injection event itself.
The patient’s condition improved dramatically over the 36 h following initial presentation, and he was subsequently discharged home with a resting oxygen saturation of 93%, with desaturation to 90% on exertion. Chest x-rays at the time of discharge and one week later (Figure 1C) were both unremarkable, with no evidence of the bilateral changes seen on the initial roentograms.
The present case illustrates the need for timely diagnosis of pulmonary oil embolism and institution of supportive care measures to limit the morbidity and mortality associated with this rare, but potentially life-threatening condition. A high index of suspicion is necessary to make an accurate diagnosis given the variability of clinical presentation and the relative paucity of specific findings on diagnostic imaging and laboratory testing results. However, in the setting of acute respiratory distress and a mechanism of injury suspicious for vascular introduction of lipid emboli, chest roentography and CT can be useful in prompting physicians to consider the possibility of pulmonary oil embolus as a diagnosis.
Member
Its pretty normal dont worry about it.
~Retired~ AR-Platinum Elite-Hall of Famer ~
Many years ago me and a friend discussed and researched why tren A seems to produce the cough far more than tren E, we came up with few reasons why but there was one what we debated a lot over. There are two systems the body use's for circulation, systematic and pulmonary. The pulmonary takes the deoxygenated blood back to the lungs for oxgenation, when we inject part of the injection will be taken up into the capillarys where it heads back to the heart out of the left atrium to the lungs and are expelled co2 and waste products in this case BA. Tren A dissassociates with BA far more easily than other hormones or ester's ie enan,hex. We came to this conculsion because he carried out a test on some tren what was causing him to cough a lot, it was a well known UGL brand. The test results showed that the tren had far too much BA which was causing the hormone to separate. We didn't get any further but on it but more or less the tren's what was causing a lot of couging post injection had a high % of BA. Inject slowly this will slow down the solution hitting the lungs instead of hitting it all in one lump, Always aspirate you could hit a vein and then the hormone and solvents (BA) will hit pulmonary circulation far faster and you are likely to cough your head off.
Productive Member
I find that is I just inject the tren and don't massage the oil in then I likely don't get the cough but once I start to massage the oils in I tend to get it.
Associate Member
That's good it means that the tren is real. When you inject pull from the nedle, if blood comes out, re inject in a diferent place and do the same step.if no blood comes out when pulling ta daaa! You didnt hit the vein so I should be fine
Last edited by Althenery; 10-20-2015 at 02:03 AM.
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